The aim of this study is to investigate the associations between post-stroke cognitive impairment (PSCI) severity and reactive astrogliosis (RA) extent on normalized 18F-THK-5351 positron-emission tomography (PET) imaging in amyloid-negative patients with first-ever stroke. We prospectively enrolled 63 amyloid-negative patients with first-ever stroke. Neurocognitive evaluation, MRI, 18F-THK-5351, and 18F-florbetapir PET were performed around 3 months after stroke. The 18F-THK-5351 uptake intensity was normalized using a signal distribution template to obtain the Z-SUM scores as the RA extent in the whole brain and cerebral hemisphere ipsilateral to stroke lesion. We evaluated stroke volume, leukoaraiosis, and brain atrophy on MRI. We used a comprehensive neurocognitive battery to obtain composite cognitive scores, and defined PSCI as a general cognitive function score < − 1. We analyzed the influence of Z-SUM scores on PSCI severity after adjusting for demographic, vascular, and neurodegenerative variables. Twenty-five of 63 stroke patients had PSCI. Patients with PSCI had older age, lower education, and more severe cortical atrophy and total Z-SUM scores. Total Z-SUM scores were significantly associated with general cognitive and executive functions at multiple regression models. Path analyses showed that stroke can exert cognitive influence directly by stroke itself as well as indirectly through RA, including total and ipsilateral Z-SUM scores, in patients with either right or left hemisphere stroke. The patterns and intensity of 18F-THK-5351 uptake in amyloid-negative patients with first-ever stroke were associated with PSCI manifestations, which suggests that RA presents a modulating effect in PSCI development.

中文翻译：

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反应性星形胶质细胞增生对中风后认知障碍影响的研究


本研究的目的是调查淀粉样蛋白阴性患者中风后认知障碍 (PSCI) 严重程度与标准化 18F-THK-5351 正电子发射断层扫描 (PET) 成像反应性星形胶质细胞增生 (RA) 程度之间的关联。曾经中风。我们前瞻性地招募了 63 名首次中风的淀粉样蛋白阴性患者。中风后约 3 个月进行神经认知评估、MRI、18F-THK-5351 和 18F-florbetapir PET。使用信号分布模板对 18F-THK-5351 摄取强度进行归一化以获得 Z-SUM 分数，作为中风病变同侧的全脑和大脑半球中的 RA 范围。我们通过 MRI 评估了每搏输出量、脑白质疏松和脑萎缩。我们使用综合神经认知电池来获得综合认知评分，并将 PSCI 定义为一般认知功能评分 < − 1。在调整人口、血管和神经退行性变量后，我们分析了 Z-SUM 评分对 PSCI 严重程度的影响。 63 名中风患者中有 25 名患有 PSCI。 PSCI 患者年龄较大、受教育程度较低、皮质萎缩和 Z-SUM 总分更严重。 Z-SUM 总分与多元回归模型中的一般认知和执行功能显着相关。路径分析表明，中风可以直接通过中风本身以及通过 RA 间接产生认知影响，包括右半球或左半球中风患者的总分和同侧 Z-SUM 评分。首次中风的淀粉样蛋白阴性患者的 18F-THK-5351 摄取模式和强度与 PSCI 表现相关，这表明 RA 在 PSCI 发展中具有调节作用。